How Much Carbohydrates Should We Eat?

Written by Dr. Steve Chaney on . Posted in carbohydrates

The “Goldilocks Effect”

Author: Dr. Stephen Chaney

 

How much carbohydrates should we eat?

how much carbohydrates should we eatThe low-carb wars rage on. Low-carb enthusiasts claim that low-carb diets are healthy. Many health experts warn about the dangers of low-carb diets. Several studies have reported that low-carb diets increase risk of mortality (shorten lifespan).

However, two recent studies have come to the opposite conclusion. Those studies reported that high carbohydrate intake increased mortality, and low carbohydrate intake was associated with the lowest mortality.

One of those studies, called the Prospective Urban Rural Epidemiology (PURE) study was published just last year. It included data from 135,335 participants from 18 countries across 5 continents. That’s a very large study, and normally we expect very large studies to be accurate. The results from the PURE study had low-carb enthusiasts doing a victory lap and claiming it was time to rewrite nutritional guidelines to favor low-carb diets.

Whenever controversies like this arise, reputable scientists are motivated to take another look at the question. They understand that all studies have their weaknesses and biases. So, they look at previous studies very carefully and try to design a study that eliminates the weaknesses and biases of those studies. Their goal is to design a stronger study that reconciles the differences between the previous studies.

how much carbohydrates should we eat studySuch a study has just been published (SB Seidelmann et al, The Lancet, doi.org/10.1016/S2468-2667(18)30135-X ). This study resolves the conflicting data and finally answers the question: “How much carbohydrates should we be eating if we desire a long and healthy life?” The answer is “Enough.”

I call this “The Goldilocks Effect” You may remember “Goldilocks And The Three Bears.” One bed was too hard. One bed was too soft. But, one bed was “just right.” One bowl of porridge was too hot. One was two cold. But, one was “just right.”  According to this study, the same is true for carbohydrate intake. High carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But, moderate carbohydrate intake is “just right.”

How Was The Study Done?

This study was performed in two parts. This first part drew on data from the Atherosclerosis Risk in Communities (ARIC) study. That study enrolled 15,428 men and women, aged 45-64, from four US communities between 1987 and 1989. This group was followed for an average of 25 years, during which time 6283 people died. Carbohydrate intake was calculated based on food frequency questionnaires administered when participants enrolled in the study and again 6 years later. The study evaluated the association between carbohydrate intake and mortality.

The second part was a meta-analysis that combined the data from the ARIC study with all major clinical studies since 2007 that measured carbohydrate intake and mortality and lasted 5 years or more. The total number of participants included in this meta-analysis was 432,179, and it included data from both studies that claimed low-carbohydrate intake was associated with decreased mortality.

 

How Much Carbohydrates Should We Eat?

 

how much carbohydrates should we eat ripThe results from the ARIC study were:

  • The relationship between mortality and carbohydrate intake was a U-shaped curve.
  • The lowest risk of death was observed with a moderate carbohydrate intake (50-55%). This is the intake recommended by current nutrition guidelines.
  • The highest risk of death was observed with a low carbohydrate intake (<40%).
  • The risk of death also increased with very high carbohydrate intake (>70%).
  • When the investigators used the mortality data to estimate life expectancy, they predicted a 50-year old participant would have a projected life expectancy of:
  • 1 years if they had a moderate intake of carbohydrates.
  • Their life expectancy was 4 years less if they had a low carbohydrate intake.
  • Their life expectancy was 1.1 year less if they had a very high carbohydrate intake.
  • The risk associated with low carbohydrate intake was affected by what the carbohydrate was replaced with.
  • When carbohydrate was replaced with animal protein and animal fat there was an increased risk of mortality on a low-carb diet. The animal-based low-carb diet contained more beef, pork, lamb, chicken and fish. It was also higher in saturated fat.
  • how much carbohydrates should we eat plantbasedWhen carbohydrate was replaced with plant protein and plant fats, there was a decreased risk of mortality on a low-carb diet. The plant-based low-carb diet contained more nuts, peanut butter, dark or whole grain breads, chocolate, and white bread. It was also higher in polyunsaturated fats.
  • The effect of carbohydrate intake on mortality was virtually the same for all-cause mortality, cardiovascular mortality, and non-cardiovascular mortality.
  • There was no significant affect of carbohydrate intake on long-term weight gain (another myth busted).

The results from the meta-analysis were very similar. When the data from all studies were combined:

  • Both low carbohydrate diets and very high carbohydrate diets were associated with increased mortality.
  • Meat-based low-carb diets increased mortality, and plant-based low-carb diets decreased mortality.
  • Once again, the results were the same for total mortality, cardiovascular mortality, and non-cardiovascular mortality.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy on both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged. Alternatively, when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to healthy aging.”

Why Were Some Previous Studies Misleading?

This study also resolved the discrepancies between previous studies. The authors pointed out that the average carbohydrate intake is very different in Europe and the US than in Asian countries and low-income countries. In the US and Europe, mean carbohydrate intake is about 50% of calories and it ranges from 25% to 70% of calories. With that range of carbohydrate intake, it is possible to observe the increase in mortality associated with both low and high carbohydrate intakes.

White rice is a staple in Asian countries, and protein is a garnish rather than a main course. Consequently, overall carbohydrate intake is greater in Asian countries and very few Asians eat a low carbohydrate diet. High protein foods tend to be more expensive than high carbohydrate foods. Thus, very few people in developing countries can afford to follow a low carbohydrate diet, and overall carbohydrate intake also tends to be higher.

how much carbohydrates should we eat aricTherefore, in Asian and developing countries the average carbohydrate intake is greater (~61%) than in the US and Europe, and the range of carbohydrate intake is from 45% to 80% of calories. With that range of intake, it is only possible to see the increase in mortality associated with high carbohydrate intake.

Both the studies that low-carb enthusiast quote to support their claim that low-carb diets are healthy relied heavily on data from Asian and developing countries. In fact, when the authors of the current study overlaid the data from the PURE study with their ARIC data, there was an almost perfect fit. The only difference was that their ARIC data covered both low and high carbohydrate intake while the PURE study touted by low-carb enthusiasts only covered moderate to high carbohydrate intake. [I have given you my rendition of the graph on the left. If you would like to see the data yourself, look at the paper .]

Basically, low-carb advocates are telling you that diets with carbohydrate intakes of 30% or less are healthy based on studies that did not include carbohydrate intakes below 40%. That is misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

What Does This Mean For You?

There are several important take-home lessons from this study:

  • All major studies agree that very high carbohydrate intake is unhealthy. In part, that reflects the fact that diets with high carbohydrate intake are likely to be high in sodas and sugary junk foods. It may also reflect the fact that diets which are high in carbohydrate are inevitably low in protein or healthy fats or both.
  • how much carbohydrates should we eat low-carbAll studies that cover the full range of carbohydrate intake agree that low carbohydrate intake is also unhealthy. It shortens life expectancy of a 50-year old by about 4 years.
  • The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.
  • Meat-based low-carb diets decrease life expectancy while plant-based low carb diets increase life expectancy. This is consistent with previous studies. For more details on those studies, see my article “Are Any Low-Carb Diets Healthy?” in “Health Tips From The Professor” or my book, “Slaying The Food Myths.”

The health risks of meat-based low-carb diets may be due to the saturated fat content or the heavy reliance on red meat. However, the risks are just as likely to be due to the foods these diets leave out – typically fruits, whole grains, legumes, and some vegetables. Proponents of low-carb diets assume that you can make up for the missing nutrients by just taking a multivitamin. However, each food group also provides a unique combination of phytonutrients and fibers. The fibers, in turn, influence your microbiome. Simply put, whenever you leave out whole food groups, you put your health at risk.

Limitations Of This Study

how much carbohydrates should we eat limitationsMy main concern with this study and all previous studies is that they lump all carbohydrates together, as if they were equally healthy or unhealthy. We should really be focusing on healthy carbohydrates versus unhealthy carbohydrates, healthy proteins versus unhealthy proteins, and healthy fats versus unhealthy fats. We should be focusing on foods.

For example, the plant-based low carbohydrate diets in this study probably had a higher percentage of healthy carbohydrates because those diets feature whole, plant-based foods. The very high carbohydrate diets in this study probably had a higher percentage of unhealthy carbohydrates. However, we have no idea whether the diets with moderate carbohydrate intake featured healthy carbohydrates or unhealthy carbohydrates. That is critical because moderate carbohydrate intake was the baseline to which all other diets were compared.

An important unanswered question is: “What is the relationship between carbohydrate intake and lifespan when most of the carbohydrates come from whole, plant-based foods?” Is low carbohydrate intake healthier or less healthy than moderate carbohydrate intake? Is high carbohydrate intake still less healthy? We have no idea. No studies have analyzed the data in that way.

Similarly, we know from multiple studies that meat-based, low-carb diets increase mortality and plant-based, low-carb diets decrease mortality when compared to moderate carbohydrate intake with no differentiation of protein source. But, what if the moderate carbohydrate group had also been subdivided into meat eaters and plant eaters? Would meat-based, low-carb diets still be less healthy than meat-based, moderate-carbohydrate diets? Would plant-based,  low-carb diets still be healthier than plant-based, moderate-carb diets? We have no idea.

 

The Bottom Line

The low-carb wars are raging. Several studies have reported that low-carb diets increase risk of mortality (shorten lifespan). However, two recent studies have come to the opposite conclusion. Those studies have low-carb enthusiasts doing a victory lap and claiming it is time to rewrite nutritional guidelines to favor low-carb diets.

However, a study just published a couple of weeks ago resolves the conflicting data and finally answers the question: “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough.”

I call this “The Goldilocks Effect.”  According to this study, high carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But, moderate carbohydrate intake is “just right.”

Specifically, this study reported:

  • Moderate carbohydrate intake (50-55%) is healthiest. This is also the carbohydrate intake recommended by current nutritional guidelines.
  • All major studies agree that very high carbohydrate intake (60-70%) is unhealthy. It shortens life expectancy of a 50-year old by about a year.
  • All studies that cover the full range of carbohydrate intake agree that low carbohydrate intake (<40%) is also unhealthy. It shortens life expectancy of a 50-year old by about 4 years.
  • The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.
  • Meat-based, low-carb diets decrease life expectancy while plant-based, low carb diets increase life expectancy. This is consistent with the results of previous studies.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged. Alternatively, when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to healthy aging.”

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Groin Pain Relief

Posted April 16, 2019 by Dr. Steve Chaney

What Is The Pectineus Muscle And Why Is It Important?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Spring Is In The Air

spring floridaI remember as a child we sang “Though April showers may come your way…they bring the flowers that bloom in May…”

Of course, here in Florida we are blessed with flowers all year, but there’s still a lovely feeling that happens in Spring.  It’s still cool enough most days to go out running, and the humidity is still low.  Traffic will soon be easing up as our friends from the north start their trek back home, and daylight savings time is giving us more time to get to the beach for sunset.  Lovely!

Fun Facts About Spring….

  • The earliest known use of the term “spring cleaning” was in 1857
  • The word “spring” has been used for the season since the 16th century
  • The first day of spring is called the vernal equinox
  • On the first day of spring, the sunrise and sunset are about 12 hours apart everywhere on earth
  • Spring fever isn’t just a saying. Experts say the body changes due to the temperature and can cause an upset in your health.
  • The actual start of spring varies from March 19th to the 21st, but it is commonly celebrated on the 21st.

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

But these activities can also cause a strain on muscles, so don’t forget to take care of yourself. If you put too much strain on muscles you haven’t used all winter, you can develop problems and need groin pain relief.

 

A Tiny Muscle Can Cause Groin Pain

groin pain relief pectineusLately I’ve had several clients come in because of groin pain that has their medical practitioners stumped.  Their symptoms are varied, but most complain that it feels like they hit their pubic bone with a rubber mallet.  Ouch!

One client loves to ride her horse, but the pain had prevented that for several weeks. Another was considering selling the motorcycle that she and her husband love because she just can’t sit on it anymore.

Several years ago, I had a male client tell me that he had this same pain and he was told it could be his prostrate causing the issue.  Fortunately, that wasn’t he problem at all.

The muscle that caused all these problems, and a lot more, is the Pectineus.

The Pectineus muscle originates on your pubic bone and inserts into the very top of your inner thigh bone (femur).

You can see the Pectineus and surrounding muscles more clearly by going to https://en.wikipedia.org/wiki/Pectineus_muscle

Most muscles have more than one function, and this is true for the Pectineus.  The function we’ll look at today is called adduction.  It brings your leg in toward midline.  If you think of a soccer player kicking the ball with the inside of his ankle, it was the Pectineus that helped draw his leg in so he could do the shot.

Each of my clients had pain while trying to bring their leg out so they could sit on their horse, or on their motorcycle.  The tight muscle was pulling on their pubic bone and causing a severe strain.

This muscle is easier to have someone else treat it for you because of its location but give it a try and see if you can locate & treat it yourself.

 

Groin Pain Relief

groin pain relief treatmentThe picture to the left is showing an athlete self-treating her adductors.  These muscles, and the Pectineus muscle, all originate at the same point on the pubic bone.  The picture is showing her massaging the middle of the adductors.

To reach the Pectineus, move the ball all the way up to the crease in your leg.  You can do the treatment with a ball, but because of the size of the muscle and its location, it’s easier to do it with your fingertips.

Sit as this athlete is sitting, and even bring your opposite leg up so your foot is flat on the floor.  For example, in this picture, the athlete would bring her right leg up so her right foot is on the floor, and then lean a bit further onto her left hip.  That opens up the area so she can reach a bit easier into the muscle while using her fingertips.

Press into the muscle, being careful to feel for a pulse, and moving if you feel one.  If the Pectineus is in spasm, you’ll know it immediately when you press on it.  If it’s not in spasm, you won’t be able to find it at all.

Remember to stay within your pain tolerance level, this isn’t a “no pain, no gain” situation.  Never go deeper than what feels tender, but not so much that you want to faint. Hold the pressure for 15 seconds. Then let up on the pressure, but keep your fingers in the same place.

Repeat this movement several times. Each time it will hurt less, and eventually it won’t hurt at all.  That’s when the muscle has completely released, and you will have relief from the pain.

It’s as simple as that!

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

calf cramps remedy bookTreat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/). It is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions.  You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain relief!

 

Wishing you well,

 

Julie Donnelly

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

julie donnellyAbout The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

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